Schrimsher Gregory W, Parker Jefferson D, Burke Randy S
G. V. (Sonny) Montgomery Veteran Affairs Medical Center, Jackson, MS 39216, USA.
Clin Neuropsychol. 2007 May;21(3):498-510. doi: 10.1080/13803390600674441.
This study examined the frequency and pattern of cognitive impairment in individuals entering substance use disorder treatment and additionally examined the relation between pattern of cognitive impairment and type of substance(s) used: alcohol (n = 116), cocaine (n = 49), alcohol/cocaine (n = 76), and alcohol/multiple substance (n = 54). The Cognistat, a screening measure of cognitive functioning, and the Addiction Severity Index were given to male veterans at the time of entering 3- to 4-week residential/day drug treatment. The most prominent areas of impairment were memory (37% of the total sample) and similarities or abstract concept formation (21% of the total sample). Moderate or greater severity of impairment was noted on at least one Cognistat scale in 35% of the participants. Results indicated no significant differences in the patterns of cognitive domain impairment between groups based on type(s) of substances used at the time of entering treatment. Multiple substance use was significantly related to greater levels of psychiatric problems as identified by the Alcohol Severity Index. Given the rate of impairment in memory and verbal abstract reasoning noted, it is suggested that cognitive screening be a standard consideration in residential substance use disorder treatment to assist in treatment selection and delivery that is optimized to provide maximal benefit to patients.
本研究调查了进入物质使用障碍治疗的个体中认知障碍的频率和模式，此外还研究了认知障碍模式与所使用物质类型之间的关系：酒精（n = 116）、可卡因（n = 49）、酒精/可卡因（n = 76）以及酒精/多种物质（n = 54）。在男性退伍军人进入为期3至4周的住院/日间药物治疗时，使用了认知功能筛查工具认知状态检查表（Cognistat）和成瘾严重程度指数。最突出的受损领域是记忆（占总样本的37%）和相似性或抽象概念形成（占总样本的21%）。35%的参与者在至少一项认知状态检查表量表上存在中度或更严重的损伤。结果表明，根据进入治疗时所使用物质的类型，各组之间在认知领域损伤模式上没有显著差异。如成瘾严重程度指数所示，多种物质使用与更严重的精神问题显著相关。鉴于所观察到的记忆和言语抽象推理损伤率，建议在住院物质使用障碍治疗中，认知筛查应作为一项标准考量，以协助进行治疗选择和实施，从而优化治疗，为患者提供最大益处。
